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Insurer to cover booster shots … even though they’re free

Priority Health will offer $0 cost share coverage for members’ third COVID-19 vaccine doses, the insurer announced. That’s despite the Biden administration saying booster shots will be available for free in the fall.

Pending federal approval, U.S. health officials plan to roll out Moderna and Pfizer vaccination boosters beginning the week of Sept. 20.

While President Joe Biden said at an Aug. 18 news briefing that the process would come at no cost, Priority Health claims it’s not confused and only aimed to clear up confusion.

“There are some instances where a provider or a pharmacist, for instance, could possibly charge an administration fee for the boosters or initial doses,” said Emily Potts, senior marketing specialist at Priority Health. “So we wanted to relay to members that all costs will be covered regardless.”

The Centers for Medicare & Medicaid Services announced on Aug. 13 that immunocompromised individuals will be able to receive a COVID-19 booster shot without cost-sharing, after the Food and Drug Administration recommended immunocompromised Americans get a third dose.

Priority Health is based in Michigan and has more than 1.2 million members. It boasts success in vaccinating those who were previously hesitant. The health plan also provided free transportation for Medicaid members attending vaccine appointments. Its internal data show no racial disparities in vaccination status among its Medicare Advantage population.

“We’ve been very diligent and sincere about believing that the vaccination process is what we want our members to participate in,” said James Forshee, senior vice president and chief medical officer for Priority Health.

Per dose, the cost of a COVID-19 vaccine can range anywhere from $3 to $37. In large orders for the U.S. government, Moderna typically charges around $15 per dose, and Pfizer charges $19.50.

The Biden administration expects to distribute 100 million booster shots for free during the fall and winter months at more than 80,000 different locations.


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